Spring 1992, Volume 17, Number 3 - Association of Schools and ...

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Volume 17, Number 3 Spring 1992
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Introducing Childr
to Optometry
A View from Down
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Association of Schools and Colleges of Optometry
The Association of Schools and Colleges of Optometry (ASCO) represents the professional programs of optometric
education in the United States, Canada and a number of foreign countries. ASCO is a non-profit, tax-exempt
professional educational association with national headquarters in Rockville, MD.
Sustaining Members
/"'• r" •':''"" %7,".- a A i*
Dr. Williiim L Cochran, President
Southern College of Optometry
Memphis, lennessee 18104
Dr. Bradford W. Wild, Dean
University of Alabama
School of Oplumi'trv
Birmingham, Alabama 35294
Vicc-i'rc'iis.'c'l
Dr. Arthur J. Afanador, Dean
Inter American University
of Puerto Rko
School of Optometry
San Juan Puerto Rko 00419
Sicf~l l Wv-':':cfj.artr
Dr. Lesley L Walls, Dean
Northeastern State University
College of Optometry
Tahlequah, Oklahoma 744f>4
Imm^riiair :, *s' JV.'siJ"."'.
Dr. Jerry Christensen, Dean
University of Missouri-St. Louis
School of Optometry
St. Louis, Missouri 63121
r.xwuiiw l^ireclor
Martin A. Wall
Dr. Jack W. Bennett, Dean
Indiana University
School of Optometry
Bloomington, Indiana 47401
Dr. Jerold Strickland. Interim Dean
University of Houston
College ot Optometry
1 loustun. Texas 77004
Dr. Jay M. F.noch, Dean
University of California
School of Optometry
Berkeley, California 94720
Dr. Aldcn \. 1 laffner. President
St.ite University of New York
State College of Optometry
New York, New York 10010
Dr. Alan I. Lewis, Dean
Ferris State University
College of Optometry
Big Rapids, Michigan' 49307
m MEMBERS
Dr. Richard 1 . Hopping, President
Southern Calilorni.i College
of Optometry
1 ullerton, California 92611
Dr. Boyd B. Banwoll, President
Illinois College of Optometry
Chicago, Illinois Wlblfi
Dr. Richard Reinke. Acting Dean
Pacific University
College of Optometry
Purest Crow, Oregon 971 Id
Dr. Richard M. I till, Dean
Ihe Ohio State University
College of Optometry
Columbus, Ohio 43210
Dr. Thomas I. I ewis. President
Pennsylvania College of Optometry
Philadelphia, Pennsylvania 19141
Dr. Larry Clausen, President
The New England College
of Optometry
Boston. Massachusetts 021 IT
l*mv:-:ral Mcm'jt"
Dr. Stewart Abel. Dean
Southeastern University
College of Optometry
North Miami Beach, Florida 13162
AifilfctL Mrubers
Dr. Anthony Cullen, Director
University of Waterloo Optometry
Waterloo, Ontario, Canada \21 3G1
Dr. John V. Lovasik
University ol Montreal Optometry
Montreal,'Quebec, Canada HIT ll'i
Dr. Oswaldo Vargas, Dean
F.scuela de Optometria
Lniversidad Social
Catolica de LaSalle
Bogota, Colombia
Dr. Giovanni DeStefani
School ol Optometry
T0039 Vinci Firen/e
Veiona, Italy
Professor 11. Barry Collin, I lead
University of New South Wales •
Optometry
Kensington, Australia N.S.VV. 2033
*Alcon Laboratories, Inc.
Allergan Humphrey
Allergan Optical
Bausch & Lomb, Inc.
*Ciba Vision Care
Coburn Optical Industries, Inc.
Corning Glass, Optical Products Division
Fused Kontacts, Inc./G.T. Laboratories, Inc.
Logo Paris, Inc.
Luxottica Group
Marchon/Marcolin Eyewear, Inc.
Polymer Technology Corporation
Reichert Ophthalmic Instruments
Sola Optical U.S.A., Inc.
Spectrum Pharmaceuticals
Sunsoft Corporation
Tura, LA.
*Varilux Corporation
*Vistakon, Inc.
Wesley-Jessen
'Advertisement in this issue
of the Journal
Editorial Review Board
Editor: Felix M. Barker II, O.D., M.S.
William Bobier, O.D., Ph.D.
Roger L. Boltz, O.D., Ph.D.
Linda Casser, O.D
David W. Davidson, O.D., M.S.
William M. Dell, O.D., M.P.H.
Ellen Richter Ettinger, O.D., M.S.
Richard D. Hazlett, O.D., Ph.D.
Catherine Hines, O.D.
Lester E. Janoff, O.D., M.S.Ed.
Nada J. Lingel, O.D., M.S.
William A. Monaco, O.D., M.S.Ed., Ph.D.
James E. Paramore, O.D.
Hector Santiago, Ph.D., O.D.
Paulette P. Schmidt, O.D., M.S.
Julie A. Schornack, O.D, M.Ed.
Leo P. Semes, O.D.
Dennis W. Siemsen, O.D.
Pierre Simonet, O.D., MSc, Ph.D.
Thomas M. Wiley, O.D, M.S.

OPTOMETRIC
EDUCATION
ISSN 0098-6917
VOL 17
NO. 3
CON
SPRING
1992
The Journal of the Association of Schools and Colleges of Optometry
SPECIAL FEATURE
Ethics and Educational Leadership
Henry H. Hayden, D.D.; Richard L. Hopping, O.D.,
D.O.S.; Alden N. Haffner, O.D., M.P.A., Ph.D.; Larry R.
Clausen, O.D., M.P.H.
A collection of speeches delivered at the inauguration of Dr. Larry
R. Clausen as president of the New England College of Optometry
examines the critical role played by leaders in institutions of higher
learning in establishing the moral tone of the community and the
post-graduate behavior of students.
73
DEPARTMENTS
Editorial: Ethics, A Bellwether of
Professional Maturity and Sophistication
Alden N. Haffner, O.D., M.PA., Ph.D. 68
Industry News
71
Resources in Review
D. Leonard Werner, O.D. 62
(Note: As Optometric Education was going to press, we
learned of the untimely death of Dr. Harris Nussenblatt
of the University of Houston College of Optometry.
A tribute to him can be found on page 69.)
MEMBER
COMMUNICATIONS
The Vision Education Centre:
A Multi-Level Educational Tool
Barbara M. Junghans, B.Optom, Ph.D. and
Sheila G. Crewther, M.Sc, DipEd, Ph.D.
The authors describe the success of the Vision Education Centre at
the University of New South Wales, Australia, in serving the needs
of optometry students, school children and their parents, the
optometry clinic, primary school teachers and researchers in the
area of children's vision.
82
Optometric Externships at Southern College of
Optometry: A Director's Perceptions
Bernard I. Sparks, III, M.S., O.D.
The author shares guidelines that have proven successful at the
Southern College of Optometry in administering extern programs.
87
Developing Optometric Preceptorships: Goal
Delineation and Program Development
Irving L. Dunsky, M.S., O.D.
The author discusses preceptorship goal delineations and various
aspects of program development, such as site selection, selection of
preceptors and preceptees and length of preceptorship.
90
About the cover: Australian school children visit the
Vision Education Centre atASCO's newest affiliate member,
the University of New South Wales.
The JOURNAL OF OPTOMETRIC EDUCATION is published by the Association of Schools and Colleges of Optometry (ASCO).
Managing Editor: Patricia Coe O'Rourke. Art Director: Dan Hildt, Graphics in General. Business and editorial offices are located
at 6110 Executive Boulevard, Suite 690, Rockville, MD 20852 (301) 231-5944. Subscriptions: JOE is published quarterly and distributed
at no charge to dues-paying members of ASCO. Individual subscriptions are available at $15.00 per year, $20.00 per year to'foreign
subscribers. Postage paid for a non-profit, tax-exempt organization at Rockville, MD. Copyright ® 1991 by The Association of Schools
and Colleges of Optometry. Advertising rates are available upon request. The journal of Optometric Education disclaims responsibility for
opinions expressed by the authors. Article copies, 16mm microfilm, 35mm microfilm and 105mm microfiche are available through University
Microfilms International, 300 North Zeeb Road, Ann Arbor, Michigan 48106.

GUEST
DITORIAI
Ethics, A Bellwether of Professional
Maturity and Sophistication
Alden N. Haffner, O.D., M.P.A., Ph.D.
The legal recognition of
optometry began in 1901
in the State of Minnesota.
From that time until 1924,
all of the states and the District of
Columbia recognized the profession
and prescribed provisions for
the regulation of its practice. In
fact, one can describe with accuracy
that, from the vantage point
of public policy, optometry is a
twentieth century profession.
The American Optometric Association
traces its founding to 1895,
just six years before the Minnesota
recognition. It is nothing less
than fascinating to note that,
throughout the expanse of more
than nine decades, the AOA has
never had a standing committee
on ethics and values. That rather
remarkable omission was altered
in 1991 when the House of Delegates
unanimously mandated the
establishment of the profession's
first permanent Committee on
Ethics and Values. This abrupt
change is the direct result of an
important presentation on clinical
ethics made in January 1991 at the
North Central Optometric Congress.
The presentation was later
This editorial is dedicated to the memory
of my distinguished colleague in public
health, Dr. Harris Lee Nussenblatt of the
College of Optometry, University of
Houston. He was an academic stalwart
and a professional champion.
published in the Journal of the
American Optometric Association
(October 1991). For the record, the
Association of Schools and Colleges
of Optometry, by resolution,
joined several state professional
associations in petitioning the
AOA to take this needed and long
overdue action.
In a careful review of files,
reports and publications of ASCO,
I have not been able to ascertain
that any previously held curriculum
conference had dealt substantively
with the subject of ethics in
the academic regimen of optometry.
In fact, there is no recorded
curriculum agreement relative to
course content, structure, time
sequence, place in the curriculum,
behavioral objectives, desired educational
outcomes, or required
qualifications of the instructor.
Suffice it to state that the optometric
educational enterprise substantially
ignored or neglected
this important academic area of
professional concern.
A recent survey of the schools
and colleges of optometry, conducted
by Dr. D. Leonard Werner
of State University of New York,
revealed a lack of consistency
among the optometric institutions
in the curricular treatment of this
subject area.
In a random telephone survey
among members of twelve state
boards of optometry, the subject
of ethics never was used as material
in oral or practical clinical
examinations of candidates for
licensure. However, every respondent
voiced to me the opinion
that the subject of ethics was an
increasingly important one. Similarly,
the National Board of Examiners
in Optometry reports that
the subject of ethics is not covered
in any depth in the written
examinations.
It is clear that the important
action of the AOA presages a
change of attitude and concern
about ethics and values in optometry.
What, then, are the implications
of this change for the
schools and colleges of optometry?
In my view, the following are
on the agenda to be addressed:
1) Ethics and values in optometry
must become a more central
concern of the professoriate;
2) There is a need to develop a
structured body of material, both
in didactic and clinical ethics;
3) There is a need to fashion a
bimodal curriculum in ethics and
values, one theoretical and conceptual
and the other clinical and
applied, and both should be based
upon the aforementioned structured
material;
4) The libraries of the schools
and colleges of optometry should
add the subject of ethics and
values to their collections, both
texts and journals;
5) A national educational conference
should be convened in
68 Optometric Education

order to develop:
A) a structured curriculum
outline for both conceptual and
clinical ethics;
B) behavioral objectives for
such a curriculum model in
optometry;
C) an outline of desired educational
objectives of such curricu
lar material;
D) desirable time sequences
in order to accomplish curricular
objectives;
E) appropriate placement in
the four year professional
program;
F) qualifications and standards
for those instructors who are
to teach didactic and clinical ethics
and values, and
G) a program to orient and
sensitize existing faculty
members.
6) Establishment of a national
resource center in the form of an
Institute of Ethics And Values In
Optometry should become a
priority;
7) The proposed Institute
should, as part of its functions,
promote scholarship and intellectual
inquiry in ethics and values in
optometry by the presentation of
an annual national conference,
either separately or in conjunction
with the annual meeting of the
American Academy of Optometry;
8) The proposed Institute, as
part of its scholarship promotion
function, should offer two yearlong
Fellowships in Ethics and
Values in order to promote intellectual
inquiry and concentrated
study; and
9) The proposed Institute of
Ethics and Values in Optometry
should be the focus for networking
with similar bodies in other
disciplines and professions.
The time to become serious,
academically and professionally,
about ethics and values in optometry
has arrived. The challenge is a
daunting one, especially in an era
of scarce resources when other
areas' professional concerns also
cry out for needed support. The
American Optometric Association
has taken an essential step. The
optometric educational enterprise
now must meet the challenge that
is before it. I am confident that it
will.
Optometry is a maturing profession.
A bellwether of its maturity
and sophistication is the seriousness
and dedication with which it
addresses its ethics and values.
Dr. Haffner is president of the State
University of New York, State College
of Optometry.
In Remembrance
Harris Nussenblatt, O.D., M.P.H., Dr.P.H., associate professor of optometry at the University of Houston
College of Optometry, succumbed to cancer on January 24,1992. E>r. Nussenblatt was 42.
Dr. Nussenblatt's career was devoted to service to optometry and public health. He served on numerous
committees and task forces concerning health care planning and personnel, public health information
and practice management. His contributions to the optometric profession were recognized by resolutions
passed by the American Academy of Optometry and the Texas Optometric Association. Dr. Nussenblatt
was also active in the American Public Health Association, serving as a founding member of the Vision
Care Section, and as editor of the newsletter for the Vision Care Section. For these and many other
activities, he received the 1991 Distinguished Achievement Award from the Vision Care Section of the
American Public Health Association.
Dr. Nussenblatt was chair of the Department of External Education at the University of Houston
College of Optometry where he was responsible for the College's external clinics and externship program.
He contributed numerous book chapters and articles in the areas of public health, practice management,
computer applications and externship programs.
At Dr. Nussenblatt's request, a lectureship has been established, "The Harris Lee Nussenblatt Distinguished
Lectureship in Public Health," at the College. Contributions may be made to:
The Dr. Harris Lee Nussenblatt Lectureship Fund
c/o The Foundation for Education and Research in Vision
University of Houston
College of Optometry
Houston, Texas 77204-6052
Volume 17, Number 3 I Spring 1992 69

THE COMPLETE APPROACH TO
HEALTHY EYES
One kind of lens and wearing schedule won't fit
every contact lens wearer.
That's why CIBA Vision Corporation is dedicated to
innovation and superior quality in offering a full
range of options in disposables, programmed
replacement, color enhancement, new specialty
lenses, classic daily wear, and lens care to meet each
person's unique needs.
See for yourself. Visit your eye care professional and
discover how CIBA Vision can provide you with the
complete approach to Healthy Eyes.
CIBAVteson
KeepingHealthy Eyes Healthy"
©Copyright 1990 CIBA Vision Corporation, 2910 Amwiier Ct., Atlanta, GA30;|^|:
4; 111

OPHTHALMIC
NDUSTRY N
Companies appearing on these pages are members ofASCO's Sustaining Member Program. Sustaining Members are listed on the
inside front cover of each issue. Membership is open to manufacturers and distributors of opthalmic equipment and supplies and
pharmaceutical companies.
CIBA Announces
Disposable Enhancing Tints
CIBA Vision Corporation
announced the first eye-color
enhancing tinted soft contact
lenses for disposable wear—
NewVues® SOFTCOLORS® (vifflcon
A) eye-color enhancing tints
in royal blue, aqua, and evergreen.
The new product will be test market
in the first quarter of 1992.
"We are very excited to test
market the popular NewVues®
soft contact lenses with the successful
SOFTCOLORS® enhancing
tint option," said Stuart Heap,
senior vice president of sales and
marketing at CIBA Vision Corporation.
"The SOFTCOLORS® line
is the most frequently fitted cosmetic
enhancement lens on the
market and NewVues lenses are
equally popular. The addition of
NewVues® SOFTCOLORS® offers
many value-added benefits to
both eye care practitioners and
their patients."
CIBA Vision Corporation will
also be the first manufacturer to
offer disposable trial lenses in eye
enhancing tints. Eye care professionals
and office personnel will
enjoy the convenience of discarding
trial lenses after use instead of
cleaning, rinsing and disinfecting
trial lens inventories.
CIBA Vision Corporation, a
subsidiary of CIBA-GEIGY Corporation,
is based in Duluth, Ga. A
soft contact lens and lens care
manufacturer, CIBA Vision Corporation
markets a wide range of
vision care products, including
the AOSEPT® Lens Care System.
Sola's ASL Wins
OLA Awards
Sola Optical's ASL single vision
lens in Spectralite high-index won
the Optical Laboratory Association's
1991 Award of Excellence in
two categories—"Best in Lens
Design" and "Best in Lens
Material."
The Award of Excellence is
presented to companies whose
products have made outstanding
contributions to the ophthalmic
industry. Nominees are selected
by OLA members, who then vote
by secret ballot to select the
winner.
"Sola is committed to helping
our customers build their businesses,
and ASL in Spectralite's
success results from that commitment,"
said Mark Mattison-
Shupnick, vice president, New
Products. "Labs like it because
it's easy to process and tint, and
dispensers like the ideal balance
of cosmetics and optical quality.
Consumers appreciate the greater
comfort and good looks."
Accepting the award for Sola at
the OLA awards banquet in New
Orleans was President Jim Cox.
"It took Sola five years to develop
Spectralite," he says. "We wanted
to ensure that the material not
only met Sola's high quality standards,
but that it also met the
needs of our customers. The hard
work paid off."
Vistakon Appoints Yamane
Director of Professional
Affairs
The appointment of Stanley J.
Yamane, O.D., to the new position
of director, professional affairs
was announced by Bernard W.
Walsh, president of Vistakon, a
division of Johnson & Johnson
Vision Products, Inc.
Reporting to Sheldon Wechsler,
O.D., vice president for professional
affairs, Dr. Yamane's
responsibilities will include managing
Vistakon's interaction with
eye care practitioners and professional
organizations as well as the
company's professional affairs
programs and activities.
Formerly the founding partner
of a two-office private practice in
Hawaii, Dr. Yamane has 24 years
of experience in private practice,
clinical research and the optometric
industry.
Active in many professional
organizations, Dr. Yamane is a fellow
of the American Academy of
Optometry (AAO) and a diplomate
of the AAO's Cornea and
Contact Lens Section, a distinguished
practitioner in optometry
of the National Academies of
Practice, a past president of the
American Optometric Foundation,
a charter member of the
Society of Contact Lens Specialists,
a member of the American
Optometric Association (AOA)
and the AOA's Sports Vision Section,
past president of the Hawaii
Optometric Association and the
Hawaii Board of Examiners in
Optometry.
"The addition of an eye care
professional of Dr. Yamane's stature
to Vistakon continues the
company's commitment to practitioners,"
Walsh added. "Dr.
Yamane will provide our company
with valuable clinical input
and excellent insight into what
our customers need."
Dr. Yamane is a 1966 graduate
of the Pacific University College
of Optometry.
B&L Focus on Planned
Replacement Program
The Bausch & Lomb Contact
Lens Division announced a new
system to help eye care practitioners
more easily manage the
transition of their patients into
disposable and other planned
replacement soft contact lenses.
"Clearly the future of this indus-
(continued on page 81)
Volume 17, Number 3 I Spring 1992 71

!gt Makes ACUVUE 8 Disposable Contact Lenses
The Prescription For Success?
ACUVUE Is
Number One In Patient
And Practitioner
I*
o?
* &
Considering the outstanding comfort, visual
acuity and convenience of ACUVUE Disposable
Contact Lenses, it's really no surprise that ACUVUE
is number one in patient satisfaction. And satisfied
patients result in fewer problems for you.
But there's more. ACUVUE patients recommend
their lenses to four times as many people as ordinary
contact lens patients. 2 And ordinary contact lens
•" 'Independent
&*n
survey, data on file:
wearers are more than twice as likely to drop out Of
their lenses. 3 So satisfied ACUVUE patients mean
increased referrals and retention—for a stronger,
more profitable practice that keeps growing.
In other words, ACUVUE satisfies your patients.
And ACUVUE can help build your practice. Both of
which satisfy you. Find out what makes ACUVUE® the
prescription for success. Convert your practice today.
VlSTAKON

Ethics and Educational Leadership
Over the past century, the issue of ethics and social responsibility in the practice of optometry
has been extensively debated and documented. But the ethical and moral obligations inherent
in positions of administrative and educational leadership have been frequently omitted from
this debate. The critical role played by leaders in institutions of higher learning in establishing
the moral tone of the community and the post-graduate behavior of students is underscored
in the following series.
The four articles that follow are based upon talks given by Dr. Henry Hay den, Dr. Richard
L. Hopping, Dr. Alden N. Haffner and Dr. Larry R Clausen at the November 18, 1990,
inauguration of Dr. Clausen as the fourth president of the New England College of Optometry.
Volume 17, Nvmlvr3 •' Spring 1992 73

Toward an
Ethical Community
Henry H. Hayden, D.D.
Mark Twain observed that man is
the only animal that blushes...or needs
to! As we perceive the current decline
of ethical standards, there is much to
blush about. In a recent interview,
British commentator Alistair Cook
stated: "America is engaged in a race
between vitality and decadence, and
it appears that decadence is winning.
Why? Conspicuous consumption,
inordinate greed, shallowness, and
eccentricity in the arts — all signs (of
ethical decline) noted in Thomas
Gibbon's Decline and Fall of the Roman
Empire."
The loss of ethical standards is often
measured by the scandals prevalent in
the banking community. Harper's Index
issued the following statistics: Amount
stolen from banks by robbers in 1989
— 50 million. Amount stolen by employee
fraud and embezzlement in 1989
— one billion.
The decline in ethics is often attributed
to the failure of the teaching profession.
As the famous Jewish theologian
Abraham Heschel stated:
"We prepare a pupil for employment
and for holding a job. We do not teach
him or her how to be a person, how
to resist conformity, how to grow in-
Dr. Hayden was pastoral minister and college chaplain
at the University of New Hampshire and the
University of New Mexico.
wardly. We teach him or her to adjust
to public opinion; we do not teach how
to cultivate privacy, how to save the
inner person from oblivion — this is
the major challenge which we face."
The decline in ethics is not only
marked by dishonesty, deceit, and
fraud in the various professions, but
also by a general unwillingness of peo-
Our purpose is to point
a way to o recovery of
ethical standards . . .
pie to sacrifice for the common good.
The failure of "noblesse oblige" ('To
whom much is given, much is required")
is reflected in the Gallup
report on charitable giving (Los Angeles
Times 9/25/90): "In 1989, households
with incomes under $10,000 gave 5.5%
of their income to charity, while those
with incomes from $50,000 — $60,000
gave 1.7%, and those earning over
$100,000 gave 2.9%."
What we have cited is but a small
sample of signs pointing to the ethical
decline in society. Our purpose, however,
is not merely to deplore but to
point a way to a recovery of ethical
standards, a recovery which would
bring about a unified, healthy society
in which public trust is restored.
The roots of morality are found in
the major living religions. We have
traditionally looked to the Ten Commandments
of the Hebrew heritage,
and the New Testament teachings of
the Christian heritage as the main
sources of our social and political
morality. The radical secularization of
the 20th century, the tremendous
growth of technology, the widespread
migrations of peoples and cultures
have created an intensely pluralistic
society in which the individual feels
powerless and isolated, and finds no
unifying moral imperative coming from
the leaders of the community. When
individualism goes too far, it destroys
the sense of the common good which
binds a society together and underscores
a sense of trust and mutual
responsibility. This theme is spelled out
in Robert Bellah's book Habits of the
Heart. In his concluding chapter he
writes:
"Many of those with whom we
talked were locked into a split between
the public world of competitive striving
and the private world of love and meaning
that makes competitive life bearable.
Some, however, were engaged in
an effort to overcome this split, and
to make our public and private worlds
mutually coherent — in a word, to recover
our social ecology . . . these
people are drawing on our republican
and Biblical traditions, trying to make
our second language into our first
language again."
Such an observation indicates the
need for a recovery of our religious
vision if we are to ensure our ethical
health. By no means does this imply
the imposition of morals from the top
down by any single religious body
such as we see in Islamic fundamentalism
in Iran (or versions of it even
in Christian fundamentalism in this
country). Rather, we look for a growing
consensus of religious- moral vision by
the coming together of the major living
religions in the realization of their
common ethical heritage. While sectarianism
may flourish, and modes of
worship differ, there is still a core of
74 Optometric Education

ethical values held in common by
Hebrew, Christian, Islamic, Buddhist,
and Confucian bodies. The Golden
Rule ("Whatsoever ye would that men
should do to you do ye even so to
them") is similar to a saying in Islam
("The noblest religion is this — that
thou shouldst like for others what thou
likest for self, and what thou feelest
as pain, hold that as painful for
others"); and in the Analects of Confucius
is written: "Do not do to others
what you do not want done to yourself
— act thus and you will arouse no ill
will." Similar statements are found in
Buddhist, Hindu, and.Taoist writings
as Bhagavan Das expounds in his book
The Essential Unity of All Religions.
It is a real hope that the major
religions offer a common vision of an
ethical society. There are signs that
major religious leaders are reaching out
to each other in the desire for a more
ethical climate. The present Roman
Catholic pope has held conversations
with Jewish, Orthodox, and Islamic
leaders within the last few years. Recently
in California, the religious
leaders of the major Catholic, Protestant,
and Jewish bodies issued a
common statement to political candidates
on the occasion of the recent
election as follows: The sole justification
for government is the common
good of a people . . . solving budget
problems by failing to protect human
persons is cruel, myopic, and inhuman.
(Los Angeles Times 10/31/90).
An ethical climate will not return
simply by fiat of religious leaders, nor
by a common intellectual assent to
snared ethical values of our religious
tradition. High ethical standards and
moral conduct are imparted from
person to person in the intimacy of the
home, and in personal relationships
engendered in small communities such
as churches, religious orders, youth
groups such as Boy and Girl Scouts,
and sometimes even by closely knit
communities. These are islands of
health in a sea of moral confusion. One
thinks of the Huguenot village in the
mountains of France (Chambon Sur
Lignon) which sheltered many Jewish
refugees during World War II even at
great peril to every member of the
community; yet all held fast and
showed moral courage in a time of
terror. In his book The Shantung Compound,
author Langdon Gilkey cites the
example of a Belgian order of monks
who during that long ordeal when the
internees had little food or medicine,
raised the spirits of all by their cheerful
corporate discipline and radiant spirits,
ensuring that all received a fair allowance
of provisions. Such examples are
an incentive to thoughtful people and
show the power of small committed
Only leaders of
unimpeachable
integrity should be
given authority
such
over
professional
groups.
groups to inspire greater ethical
sensitivity in the larger community of
state and nation.
A further incentive to ethical conduct
may be found in the very psychicphysical
nature of the human body.
Simply stated it means that when one
lies, cheats, or steals, one commits
damage of a measurable amount
against one's own bodily health. The
moral universe is grounded in the very
nature of humanity. In the device
known as the "lie detector," it is
observed that when a person denies
what his senses have seen and recorded,
a disturbance is set up which
raises blood pressure. When one
continually violates the trust between
people and destroys the bonds of
human community, then the perpetrator
lives in a guarded, anxious, and
defensive manner — a lifestyle that is
measurably destructive. This is documented
in Sidney Jourard's book The
Transparent Self.
What then would these insights
mean in the establishment of an ethical
professional society? It would seem to
imply a clear and forthright statement
of an ethical code which assumes the
inherent worth of all humans, and the
need to treat all with consideration, and
without partiality.
Secondly, it would imply that each
member make a solemn commitment
to such a code, and that penalties be
attached for violations. When these
violations are clearly intentional, then
that offending member should be
removed from the professional group.
Lastly, it would imply that the
person, or persons, in authority in such
bodies be people of personal integrity,
exhibiting the highest standards of
ethical behavior, never counting themselves
above the law, and calling the
group to account when unethical conduct
occurred. Only leaders of unimpeachable
integrity should be given
authority over such professional
groups.
A disciplined, highly ethical professional
group can set a shining example
to a confused and directionless society,
lead the way to a recovery of ethical
health, and foster a climate in which
the vulnerable individual feels safe in
entrusting himself or herself to professional
care.
Did you know , . .?
Awards are now available that encourage optometry students
to explore the areas of professionalism and ethical practice. The
Gary I'. Gross, O.D., Memorial Scholarships (S2500) are awarded
each year to two students by the American Optometric Foundation.
The award honors the memory of Dr. Gross and "perpetuates the
high ideals of professionalism and leadership in optometry that
he exemplified."
Winners of the 1"W1 awards, presented at the North Central
States Optometric Council Meeting, were Amy C. Treichel, Indiana
University School of Optometry and Peter J. Heinen, Southern
California College of Optometry. For information on next year's
awards, contact the American Optometric Foundation, 4330 Jiast-
West Highway, #117, Bethesda, MD 20814.
Volume 17, Number 3 / Spring 1992 75

Ethics in Optomelric
Education and Practice
Richard L. Hopping, O.D., D.O.S.
The New England College of Optometry
and its predecessor institutions
have developed a rich heritage over the
96 years of its existence, and that has
come about because of the distinguished
faculty and presidents who
have gone before you. They each
believed in this institution and
struggled with faith and courage to
bring it to its present position. They
contributed to the furtherance of a
dream, and today the mantle of presidential
leadership is being placed fully
on Dr. Clausen's shoulders to further
continue that dream. Institutions of
higher education do not grow by themselves
but are built and developed by
the faculty and leaders who believe in
them. I have every confidence that
NEWENCO is in good and capable
hands and that under your leadership
this institution will move into a new
era of excellence.
As president, you have the responsibility
for the general welfare of this
institution and for those students who
will become your graduates. Your graduates
must leave your care and guidance
professionally competent, socially
conscious and community oriented.
As President Abraham Lincoln said,
"Upon the subject of education, I can
Dr. Hopping is president of the Southern California
College of Optometry.
only say that I view it as the most important
subject which we as a people
can be engaged in." Indeed, my 18
years in optometric education have
continually reinforced my belief in that
concept.
However, it was President Theodore
Roosevelt who said, 'To educate a man
in mind and not in morals is to educate
Thus, professions are
given, by law, a high
degree of autonomy on
the theory that only
those in the profession
have the competence
to regulate it.
a menace to society." From these
statements one can see quickly that
the presidency of an educational institution
is an awesome obligation that
words cannot fully describe.
Dr. Christensen, as president of this
college of optometry, must accept the
challenge and responsibility of helping
NEWENCO's students and the practitioners
in the profession to address
the issues of professional ethics. It is
the duty of each of us in optometric
education to foster in our students the
ability to recognize their ethical choices
and to enhance their capability for
making the right decisions.
Actions taken by today's optometric
administrators will help to determine
the future of our profession and its
direction as we move toward the 21st
century. Our responsibility is great as
we provide guidance to our students
and graduates and instill in them high
ethical values along with a strong social
commitment that the true professional
person must have.
Perhaps with all the present changes
currently taking place in health care,
we may need to define just what a true
professional is. A few years ago, Dr.
Harold Enarson was the commencement
speaker at SCCO. Dr. Enarson
delved into the meaning of the word
"professional." He offered many ideas,
but the one that affected me most
keenly was taken from William McGlothin's
book, The Professional Schools. The
distinguishing addition was the consideration
that a profession is given
monopoly privileges to largely control
its own work. Thus, professions are
given, by law, a high degree of autonomy
on the theory that only those in
the profession have the competence to
regulate it.
It is assumed that the professional
person can be trusted to function with
a higher degree of autonomy once a
public authority, through governing
mechanisms such as licensure, authorizes
the privilege of practice. This
precious gift of trust is based on the
belief that professionals live by a
demanding code of ethical behavior.
Now it becomes even more clear why
ethics is so critically important, and
why it is necessary to ensure that the
optometrist practices in an ethical
manner. If we as professionals are to
retain the privilege of autonomy to
govern our own profession, it is
imperative that we fully accept this
responsibility and not misuse that
privilege. Over the years, many have
tried to take this privilege from us, and
we have won some battles and lost a
few. We must not lose any more.
Edward Bacon, in his Design of Cities,
states, "We are in danger of losing one
of the most important concepts of mankind,
that the future is what we make
it. Our greatest challenge, therefore, is
to control our own destiny; this should
76 Optometric Education

e our greatest desire." The will to
control the ultimate destiny of optometry
must be instilled in the students
of today while they are under your
nurturing care. The strength of our
profession is and will continue to be
equal to the number of optometrists
times their will. The question is
whether we, as optometric administrators
and educators, can sufficiently
instill that will in our students while
they reside in our institutions. We must
impress upon them the value of ethical
leadership so that our profession will
be continually mindful of the great
responsibility that optometrists have as
they provide the vision care for the
people of this nation. The health care
professions are rightfully expected to
adhere to a higher code of ethics and
standards than do those in other occupations.
This is the price that optometry
as a profession must pay for the
privilege of self-determination and selfpolicing.
It must be understood that, as was
so aptly stated by a famous son df this
Commonwealth, President John R
Kennedy, "For of those to whom much
is given, much is required." Therefore,
it follows that NEWENCO graduates,
in completing a fine optometric education,
must fully accept the mantle of
the health professional upon their
shoulders, and that acceptance will
"For of those to whom
much is given, much is
required."
—President
John F. Kennedy
require a firm commitment to ethical
principles.
As president of the College, Dr.
Clausen, you have a most definite
responsibility to guide your students
and to help establish the standards and
goals for faculty as they teach the
necessary professional skills. You also
have a responsibility to create a sensitivity
to all people with differing
values while assisting your students to
recognize and better understand the
complex community and social problems
that exist in our real world.
As you set the tone of your administration,
you will be faced with considerable
decision making. Your example
of ethical decision making will set
the tone and standards under which
your administration, faculty, students
and even the board of trustees of the
college will operate.
But along with demonstrative examples
of your own ethical behavior,
ethics must be taught in the classroom.
Although for many years it was my
belief that ethical standards were established
in childhood and were not acquired
later in life, I have become
convinced that educators have an awesome
and continuing responsibility to
instill in their students the ability to
develop moral standards and to assist
students in establishing their own
personal standards as well as those
expected of a health care professional.
Your students will be influenced and
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molded by what they encounter and
confront in the classroom and in your
clinics as well as in their relationship
with faculty and administrators. I
believe strongly that we, as optometric
educators, have a most definite responsibility
to provide ethics education for
our students. We must not have students
leave our institutions morally
confused and unable to make ethical
decisions of their own.
All optometric educators have a
responsibility to provide moral and
ethical direction to all optometric students
if we are to have students demonstrate
a moral and ethical commitment
to our society. As optometrists and
health professionals, we are involved
in a significant trust relationship with
people, and that trust must be upheld.
As students at the New England
College of Optometry become a part
of the optometric profession and begin
to define their professional and ethical
responsibilities, you as the president
and your faculty can play an important
role, providing moral and ethical
direction and a commitment to a just
society as embodied in the precepts
of the Optometric Oath that has been
adopted by the American Optometric
Association and the Association of
Schools and Colleges of Optometry.
Over a century and a half ago, Alexis
de Tocqueville noted, "America is great
because America is good. If America
ceases to be good, she will cease to
be great." I would argue that optometry
is great because optometry is
good. Dr. Clausen, as president of this
distinguished college of optometry,
you must provide leadership so that
your students will graduate with the
high ethical standards that will ensure
that optometry will never cease to be
good and will therefore continue to be
the great and responsible profession
that we know it to be.
If we can ensure that all future optometrists
will uphold the public trust
granted to us as health care providers,
then the future of optometry is in safe
hands and its future will be eternally
bright.
Ethics and the
College Presidency
Alden N. Haffner, O.D., M.P.A., Ph.D.
This is not only a gala occasion to
celebrate the designation and installation
of the fourth president of the New
England College of Optometry. It is,
as well, the celebration of the process
of continuity of institutional leadership
which began more than a century ago.
New England, a cradle of liberty,
democracy, higher and professional
education, justice and social progress,
has been known for its leadership in
each of these areas. That leadership has
Dr. Haffner is president of the State College of Optometry,
State University of New York.
been essential to our advancement as
a society and to the patrimony of this
great nation. It is in that context that
I wish to address my remarks.
The role of a president of a college
of optometry today is not, in my view,
remarkably different from that of
earlier presidents. The difference, and
it is considerable, is in the profession
itself. Optometry has been dramatically
altered in the last thirty years.
Perhaps the most critical change has
been its movement from the periphery
of health care into the mainstream.
Optometry's role and mission have
shifted so that it has emerged as a
primary care health discipline. This
emergence has taken place within the
framework of rapid and frequently
chaotic changes in health care as a
public utility — an indicator of optometry's
remarkable strength and vitality.
But our profession will not prosper and
grow without the fundamental intellectual
and academic energy of its
institutions. That has been true in the
past and it is so now.
What, then, do we seek in a leader
of an institution in this profession? We
seek a leader who is agile of mind and
fiercely independent. A leader must be
wise enough to seek the counsel of
faculty while synthesizing with its
frequently divergent views. A leader is
accountable to the governance structure
while simultaneously helping to
shape and focus its policy deliberations.
A leader must present fresh ideas
based upon the needs of the profession.
A leader will challenge courageously
the quality of intellect of both faculty
and peers. Finally, a leader will seek
out, encourage and support new young
people whose academic and intellectual
abilities may be honed into leadership
for future faculty, leadership for
future administrators, leadership for
future professionals, and leadership for
future presidents. For after all, what
then is leadership if not to help define
the future?
The institutional leaders in optometry
have much to say in the success
or failure of the profession. Each era
in our history has been important and
the role of the college president is to
help shape that history through the
education of the progeny. The college
president in optometry must also be
instrumental in seeking new ways to
78 Optometric Education

efine the intellectual dignity and
integrity of the profession's knowledge
base.
The remarkable American educational
statesman, Clark Kerr, once
wrote:
"The variable in each situation is the
president — his or her strategies and
tactics, skills and character. The comingling
of environments and character
constitutes a great drama played
out on many stages before many
audiences. Heroes and villains emerge:
Courage as well as cowardice is shown:
Wisdom and folly are variously dis-
A leader will challenge
courageously the
quality of intellect of
both faculty and peers.
played: And nobody can really know
precisely how many or how much of
each are the result of time and place,
on the one hand, or of strong, wise
human character, on the other. That
is the eternal puzzle of the college
president."
My friend and colleague, Larry
Clausen, may your tenure as leader be
filled with courage and tempered by
a wise human character. May the New
England College of Optometry be the
beneficiary of your leadership so that
it may enhance and promote our
profession in the years to come.
Ethics and
Administrative Leadership
Larry R. Clausen, O.D., M.P.H.
I have chosen through this ceremony extent of the problems we will confront
to introduce the topic of professional in the next ten years or even the next
ethics as a fundamental concept of administrative
leadership. It is my prem­
The topic of ethics focuses on a more
two years.
ise that leadership, especially over time, basic issue. It speaks to the methods
is dependent on the consistent application
of ethical and moral principles. seen situations, the standards of con­
that we will use to approach unfore­
It is perhaps more traditional in an duct that we will abide by in reaching
inaugural address to speak of future decisions, and the moral principles
goals, institutional mission, and action which will dictate responses to complex
problems.
strategies for success. To do so requires
a set of assumptions with regard to Ethics is more important now than
future problems, external environments
and available resources. But we between right and wrong is becoming
ever before. Our society's distinction
work in a changing and ambiguous blurred. We don't want to be unethical,
environment. We can not know the full but at the same time we don't want
to be more ethical than we have to be.
This approach creates a confusing and
Br. Clausen is president of the New England College limited orientation toward ethics. It
of Optometry.
implies that it is acceptable to approach
Volume 17, Number 3 / Spring 1992
the line of right and wrong as long as
one doesn't cross it. Such a philosophy
undermines the ability to lead, and
over time to distinguish right from
wrong.
Unfortunately, the lack of compliance
with moral principles is evident
too frequently among people in leadership
positions. We observe this in
government, within the world of education,
professional sports, in fact, in
all professions and walks of life. Almost
every day we are made aware of individuals
who have failed to uphold
ethical principles.
Recently the Boston Globe's front page
outlined the allegations against Senator
Alan Cranston of California. The article
related the Senator's apparent acceptance
of $850,000 from Charles Keating,
and the Senator's subsequent interference
in the federal government's investigation
of Keating's Lincoln Savings
and Loan. The failing of this single
savings and loan will cost the taxpayers
approximately two billion dollars. The
most disturbing information in the
Globe's article was not the dollar magnitude,
but rather Senator Cranston
calling it absurd to suggest that fundraising
and substantive issues are
separated in the Senate. At what point
did Senator Cranston's or the Senate's
concept of acceptable ethics cross the
line?
If we play the game of walking the
ethical tightrope, are we able to clearly
differentiate right from wrong? I
believe not. The practice of ethics in
one's career is more than being perceived
as ethical; it is being ethical. We
must be sure of our basic principles.
We must reflect upon them and upon
our practice. We cannot avoid the
struggle, the introspection that is
required to find appropriate answers
to ethical questions.
79

We cannot deny the existence of
ethical questions within colleges and
universities that are expected to serve
a variety of interests both within and
outside of the higher education community.
As a private college, how do
we find moral balance in decisions
weighing faculty salaries against tuition
levels, or in decisions concerning
admission standards during periods of
declining enrollments? Do we, the
faculty and administration, accept
appropriate accountability for the
failure of students to learn? Are we just
in the application of standards for promotion
and tenure, or do we exhibit
professional bias and insensitivity?
It is critical that we continually reflect
upon our practices. The faculty member
or administrator who fails to do
this will be less effective in his or her
role. To be directed only by tradition
or custom limits our growth as moral
beings. Ethical action arises when an
individual begins to reflect on what
principles will govern his or her actions,
particularly when those actions involve
the rights and interests of other persons.
You have heard three speakers
address the topic of ethics from varying
perspectives, but all with the underlying
assumption that ethics, moral
judgment, is central to making right
decisions. I invited these speakers
because in one way or another they
have served as role models, as mentors,
as teachers in my development. They
are individuals of integrity, who,
through word and action, harbor and
express a moral philosophy much
better than I could do. Their messages
were more for my ears than yours. They
contain advice and challenge designed
to aid me in my role as president.
It is important that I reflect upon the
values and personal qualities which
these leaders embrace. These include
the commitment to serve the common
good, to generate standards of excellence
and hold themselves to such
standards, to lead lives of integrity
which do not exhibit differences between
word and deed, and to recognize
fundamental equality in all circumstances.
These values are essential to
the presidency.
William May, a scholar in ethics,
notes that the moral disposition that
the professional brings to the organization
shapes his or her approaches to
problems . . . (and) the level at which
we tackle them. Perhaps the more
sanguine message in May's writing is
the recognition that ethics is the fibre,
the resources with which we survive
moral crisis to function another day.
My objective is to begin to shape a
concept of moral philosophy for the
New England College of Optometry,
to recognize that I, together with the
broader college and professional community,
have the responsibility to
influence through definition and action
our ethical culture and to strive to
attain higher levels of both individual
and institutional objectives. This need
not be difficult. It can be achieved
through consistent attention to basic
human values.
Let me close with words from
Kenneth Wenker's book, Foundations of
Professional Morality:
"It we want to do the right kinds
of actions consistently, we need first
to be persons of moral character . . .
A good understanding of right and
wrong comes less out of sophisticated
ethical theories and more out of a
concern for humanity... an awareness
of fundamental human equality, and
a healthy relationship between reason
and emotion."
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Industry News
(continued from page 71)
try rests with planned replacement
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Harold O. Johnson, president of
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planned replacement and disposable
contacts," added Johnson.
At the heart of the new Bausch
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trial fitting, the practitioner has
the option of prescribing either
the new Bausch & Lomb See-
Quence 2 disposable lens, or a
planned replacement lens from
the Medalist line. Products
included in the system will be
made available in three base
curves by early 1992.
Bausch & Lomb also has
formed a top-level consulting
organization to provide comprehensive
training in the implementation
of planned replacement
programs in optometric offices
nationwide. The Bausch & Lomb
Practice Management Consulting
& Training Group, will work full
time to help practitioners manage
the transition from standard lens
wear to planned replacement programs
for their patients. The
group consists of a team of
experts with broad experience in
general business, marketing,
finance, computer systems, staff
training, inventory management,
and knowledge of the current
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According to C. David Barone,
general manager & executive
director of the Training Group,
"We are absolutely committed to
the concept that eye care practitioners
can improve their contact
lens practice with planned
replacement and we're going to
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Allergan Introduces
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Allergan recently introduced
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extension of the popular Zero 4®
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additional colors—Emerald and
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in mid-1992.
SofTints lenses differ from
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"We anticipate a very favorable
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They will serve the eye care practitioner
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Coming's UV Data
Confirmed in Article
An article written by Denwood
F. Ross III, published in a recent
edition of Applied Optics, confirms
the data published by Corning
about its photochromic glass
lenses. Corning research consistently
determines that its four
key photochromic lenses (Photo-
Gray Extra,® PhotoBrown Extra,®
PhotoGray II,® and PhotoSun II®)
block between 93% and 98% of
UV-A radiation and 100% of UV-B.
The data published in the Applied
Optics article, entitled "Ophthalmic
lenses: accurately characterizing
transmittance of photochromic
and other common lens
materials," matches Coming's
published data.
The third-party evaluation used
appropriate precision testing
equipment and methods for accurately
characterizing and performance
of photochromic lenses.
The Applied Optics article also discusses
the care necessary in
obtaining accurate measurements
of the transmittance of photochromic
glasses. This is mainly
because these transmittances
depend on illumination levels,
other environmental conditions,
and the measurement process
itself.
This research verifies that optical
professionals can rely on
Coming's published UV absorption
values for photochromic
lenses with assurance that they
represent an accurate gauge of
the performance of these lenses.
For further information or a
reprint of the article, please write
to Corning Incorpirated, Optical
Products Department, MP-21-2-1,
Corning, NY 14831.
Logo Paris Launches
New Marketing Campaign
Logo Paris' launch of a new
marketing campaign "The Professional's
Brand" was greeted
with overwhelming enthusiasm at
Vision Expo West. Logo Paris
recently introduced a new print
ad campaign positioning the company
and its products as "The
Professional's Brand." The graphics
in the trade magazine print
ads feature Logo's professional
customers including optometrists,
opticians and ophthalmologists
shown in their working environments
endorsing Logo Paris'
products and service.
Fredric Grethel, vice president
of sales & marketing of Logo
Paris stated, "Everyone I've
spoken to about our new corporate
theme agrees quite readily
that 'The Professional's Brand SM ' is
very appropriate for Logo Paris.
Simply stated, it means that Logo
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without relying on gimmicks. We
foresee tremendous potential for
this communications campaign
and we look forward to watching
it develop." For further information,
contact your Logo Paris sales
consultant or call 1-800-556-Logo.
Volume 17, Number 3 / Spring 1992 81

The Vision
Education Centre
$ A Multi-Level Educational Tool

Abstract
Optometric educators have a
responsibility not only to serve
students undertaking studies in
optometry, but also to save and educate
the 'wider community. At the
University of Neiv South Wales,
Australia, a Vision Education Centre
(\''bC) has been founded which is
of mutual benefit to optometry and
to the local community. The centre
is an innovative and unique multi-
Iroel learning and teaching centre,
which not only addresses the needs
of optometry students to gain clinical
and communication skills but also
provides vision care ami education
in visual science to local schools. It
is a centre where young patients can
come in large groups, and actively
learn about visual science during an
attendance at the clinic for a routine
eye examination.
The Vision Education Centre has
been highly successful and provides
direct benefits to optometry students,
school children and their parents, the
School of Optometry Clinic, primary
school teachers, and researchers in
the area of children's vision. Indirectly,
the centre is also a means of
increasing public awareness of both
the University and the profession of
optometry. The increased pediatric
experience has served to heighten an
awareness of the visual needs of the
young patient, and the obligations of
optometiy to younger members of the
communilv.
Introduction
The Vision Education Centre (VEC)
at the University of New South Wales,
Sydney, was conceived as a means
by which final year students could
see more pediatric patients. Basically,
the Centre is a means of attracting
young patients to our clinic by providing
the patients with an exciting
and meaningful learning experience.
Dr. Junghans is a lecturer at the School of Optometry,
University of New South Wales, Sydney, Australia,
and coordinator of the Vision Education Center.
Dr. Crewther is a senior research fellow at the School
of Optometry, University of New South Wales, Sydney,
Australia, and designer of the Vision Education
Centre.
The University of New South Wales School of Optometry
became an ASCO affiliate member in January
1992.
Despite its simplicity, the potential
use of the VEC as a tool to satisfy
a number of teaching, research and
community-service goals in a timeefficient
manner readily became
apparent. This is particularly pertinent
at a time when resources and
funding are being cut back in real
terms, and it is necessary to take a
fresh look at curricula, and to implement
alternate teaching methodologies
that more successfully stimulate
the learning process. 1 Such a call for
restructuring of academic programs
to ensure balance between the various
facets of clinical and science disciplines
and to improve the quality
of teaching within optometry has
recently been made. 2 ' 3
The plan for the VEC is based upon
interactive learning programs between
primary and tertiary students,
interaction across the disciplines of
education and optometry, and extension
to research opportunities. As
such, it provides an excellent model
of a multi-functional facility. It also
provides an example of an alternate
teaching strategy with multiple goals.
The success of the VEC has been
far greater than anticipated. The local
school teachers are grateful, the
families of those children identified
to have visual problems are very
thankful, and a new enthusiasm for
pediatric optometry has spread
through the school. In addition, the
children bring a breath of fresh air
into our school every time a class
visits, which has had a most positive
effect on all our staff. This paper
describes the centre as it has run since
mid-1990.
How the VEC Operates
The Vision Education Centre invites
classes from nearby infants and
primary schools to visit the School
of Optometry as an excursion. Each
class is divided into two groups.
While one half has a comprehensive
eye and vision screening by fourthyear
students, the other half receives
a short talk followed by interactive
activities based on optics, physiological
optics, ocular anatomy and eye
examination techniques. After one
hour, the children have refreshments
and the groups interchange. An
activity book with diagrams, word
games and home-based projects is
given out at the end of the day to
reinforce terms and concepts covered
during the visit. To encourage periodic
visits to the centre, three educational
packages have been prepared
with information appropriate
for infants (ages 5-8), lower primary
(ages 8-10) and upper primary (ages
10-12). Thus, it is intended that
children will come to the centre every
three years.
Parents and teachers are given
questionnaires before the visit so that
children with particular visual or
educational concerns can be identified.
A set of lesson plans is sent to
each teacher beforehand, to allow the
class to prepare for the day. After the
eye exam, parents are sent a report
of the findings, and teachers are
alerted of the children who require
further attention. Parents of any
children found requiring further
investigation have the choice of
consulting their local practitioner, or
the clinic at the School of Optometry
for a more detailed investigation.
As our graduates move
out into the optometric
community, it is hoped
that they will take with
them extra confidence
to meet the demands of
young patients.
The children are met outside the
building at the bus and welcomed.
At the reception area they are given
prepared sticky name tags which are
of two colors to indicate the two
groupings for the day (it is best to
put a little more than half the boys
in the first science talk). The children,
in walking to the consulting rooms
and the classroom area, are given a
description of the rooms they pass
— head of school, research labs,
administration offices, etc. In this way
they are introduced to the range of
activities of a university, and the similarities
between their own school and
the "schbol of optometry." It is important
with the younger .children, to
include t\ group visit in a consulting
room before any of the individual eye
examinations commence, as some
children find the similarity between
the dentist's and the optometrist's
Volume 17, Number 3 / Spring 1992 83

chairs a little disconcerting, especially
as their mothers are not with them.
The two groups are then separated,
coming together again at morning tea
for the changeover.
The eye screening is a little less
than a full examination and consists
of: external and internal ocular health
assessment (direct ophthalmoscopy),
retinoscopy, ocular motility, amplitudes
of convergence and accommodation,
phorias, accommodative facility
by flip-spheres, fusional reserves
by flipprisms, stereopsis, and color
vision by Ishihara, SPP or D-15. A
limited subjective routine is carried
out if necessary. Further investigations
such as biomicroscopy, noncontact
tonometry, the Keystone
routine and autorefractor measurements
are carried out if time allows,
so that the final year students can
gain additional practice with these
instruments. Most of these tests are
carried out one-to-one in the regular
consulting rooms. However, a few
tests such as stereopsis and color
vision are carried out in the general
children's vision clinic, which acts as
a holding area for the children during
the morning. Additionally, research
staff are given access to the children
to test prototypes of instruments
under development, and final year
students are able to add extra tests
or utilize data for their final year
research projects.
The students being given the
education segment are taken to an
open plan preclinical teaching area
where they sit on scatter rugs during
the talk, and then break up into
smaller groups to do the activities
which are placed on tables and
benches around the room. The science
activities cover the areas of eye
health and safety, methods of examining
eyes, refraction, reflection, color,
ocular anatomy, and behavioral
vision. This area has been made more
cheerful with numerous wall poster
photographs of animal eyes which are
referred to extensively during the
talks. Photographs are taken during
the morning and sent to the school
as a follow up to the visit for use in
class projects and to show parents.
To run a VEC morning with up to
36 children, we have found a need for
at least two extra members of optometric
staff above the normal general
clinic staffing requirements. The first
person runs the educational activities
with the help of four second-year
optometry students. The second
additional person is required to keep
a tally on where all children are, coordinate
the consulting rooms and the
change over to the educational location
(currently this person is a resident
optometrist). The regular clinic
supervisor has an additional responsibility
of collating the overall pass/
fail results onto a master class list for
the teacher's information, and ensuring
that the letters to parents advising
the screening results are in order.
Although the reception staff have the
usual patient records to fill out, this
is done in advance from class lists
supplied by the schools, and the
actual morning of VEC clinics is less
busy for them. The VEC clinics do
not directly generate any dispensing
requirements, and hence, the regular
dispensing supervisor is not required.
It is necessary to appoint an overall
coordinator to promote the scheme,
to plan bookings by the schools, to
communicate with schools, to carry
out the day-to-day running of the
centre, and to prepare the lesson
plans, science activities and activity
booklets. We believe that one important
aspect of the success of the
scheme is that the key optometric
personnel who are in contact with the
teachers have some experience with
young children and education. An
ability to communicate with teachers
about children and learning is essential.
Discussion
The VEC is a scheme whereby
everyone appears to be a winner. The
good feelings which have been generated
from the increased student
enthusiasm, increased contact with
the local community, increased
awareness of pediatric optometry and
increased reflection upon what we are
really trying to do, have prompted
many clinic supervisors to comment
that it is the best thing to have
happened within the school for a long
time. The benefits are both short-term
and long-term.
Benefits to
Optometry Students
Final year students see many more
young patients as a result of this program.
The VEC attracts a part of the
community which would otherwise
not be motivated to attend for eye
examination, and provides ample
opportunity for optometry students
to examine young healthy eyes and
broaden their perception of eye care
delivery. Most students find that
working with young patients can be
quite challenging and enjoyable. The
Centre provides students with the
opportunity to:
• see a wide range of normal
healthy eyes;
• better understand how consultation
routines can be modified to suit
the age or developmental status of the
patient;
• develop interpersonal skills appropriate
to younger patients;
• devise consulting room accessories
more suitable for the young;
• understand their own aptitude
for pediatric optometry;
• understand the needs and rights
of the younger patient;
• see patients who are not presenting
because of perceived problems.
The second-year students who act
as assistants during the educational
segment and interactive learning
activities also benefit greatly. These
students are rostered on for four
weeks and appear to enjoy the experience.
They are required to set up
the morning tea, supervise groups of
four to five children for the activities
during morning tea, and tidy-up.
Thus, they have the chance to:
• develop child-handling skills in a
game-like atmosphere. It is anticipated
that this experience will make
the final year less threatening in terms
of patient handling and communication,
and that they will then be more
able to devote their attention to optometric
matters;
• consolidate the basic optometric
knowledge needed to give lay explanations.
(Eight-year-olds will not
accept a recitation of a textbook as
an explanation of their question!);
• develop initiative, leadership and
organizational skills;
• observe the delivery of a talk on
eyes and vision, typical of that which
they might be called upon to give to
school groups once they are in private
practice.
Due to the large numbers of young
patients of all visual types brought
into our system because of the
Centre, the school is now able to provide
a suitable range of experiences
and projects for post-graduate resident
optometrists and research
students.
84 Optometric Education

How the VEC Benefits the
School of Optometry
The clinical training of optometrists
requires that each university has
access to a large pool of patients. The
VEC directly promotes the existence
of the optometry clinic to two important
local resources: school teachers
and parents. The class teachers accompanying
the children are always
interested to learn of the clinic (many
request an eye exam along with the
children). Parents are alerted to the
clinic by way of completion of the
consent form and the notification of
the screening results. In addition, the
activity book taken home by the
children reminds parents of the visit
made by their child to the School of
Optometry. With two class visits per
week, our clinic will benefit from an
increase of over 700 young patients
in half a year.
A specialty clinic within our system,
the Children's Vision Clinic, also
directly benefits from the VEC program.
The parents of the majority of
the children who require further
investigation after a VEC screening
seek the services of this clinic. More
children with binocular vision anomalies
and color vision anomalies are
thus being seen by our students.
Talking weekly with primary
school teachers provides much interesting
anecdotal information upon
which to follow up. As a result, the
contact with schools has led to a
revival of interest in our staff in the
role of vision in academic performance
in the young.
Another aspect of the benefits
derived from the foundation of the
VEC is that our approach to the
teaching of pediatric optometry and
interpersonal skills has come under
scrutiny. As one clinic supervisor
stated, "I didn't realize that some of
our students could be so scared of
children!" The content of lectures, the
timing of presentation, what constitutes
a minimum screening, what is
to be accepted as satisfactory visual
performance — all have been
reviewed. The shortcomings of utilizing
general consulting room equipment
with children has had to be
addressed and some equipment more
suitable for use with children has
been purchased.
In a wider sense, the breadth of our
involvement as optometric educators
has also come under review. Curriculum
development in any of the
sciences should be based on an
orderly plan moving from contact
during early childhood through to
adulthood. Primary, secondary and
tertiary levels of education, including
optometric education, should not be
seen in isolation. In Australia, the
optometric profession has no input
into the formal development of
primary and secondary school ocular
and visual science curricula, although
most school children experience
lessons on ocular health and anatomy
and the science of light and color, at
some stage during their school career.
As a consequence of the VEC program,
children now contact our
school for help with their school
projects. Should we be direct providers
of information to the community
as a whole? Should we seek positions
as consultants on the state boards of
education to ensure graded, quality
presentation of the visual sciences?
Addressing these questions in a
professional manner can only be of
benefit to the School of Optometry.
How the VEC
Benefits Children
For most children, the eye examination
during a visit to the VEC is
their first contact with an eye care
practitioner, and thus, the Centre
fc. • . ".
provides health care they otherwise
would not usually receive.
It is hoped that the educational
segment, because it is presented as
a school excursion, will have a lasting
impression of children and emphasize
the important role that eyes play
in their lives, stimulate an interest in
the sciences by way of a memorable
hands-on science lesson, and give an
insight into the full spectrum of
formal education, which may serve as
a motivating force through their
primary and secondary years.
How the VEC Benefits
School Teachers
The school teachers who have
visited the Centre have been immensely
impressed. They greatly
appreciate the input into their health
and science programs. Since most primary
school teachers are not primarily
science teachers, the presentation
of science activities in a dynamic, new
setting is a way in which young
people can be introduced to science
in a very positive way. Many teachers
have commented that our, presentation
of visual science and ocular
health is far more stimulating than
they could ever achieve using the
resource material available to them.
A visit to the VEC is used by many
Volume 17, Number 3 / Spring 1992 85

teachers as a theme for further classroom
work in science and in other
areas of learning, such as the development
of writing skills. Consequently,
thank you letters from the
children adorn the walls of the reception
area to our Clinic. In addition,
the photographs taken during a visit
are sent to the school and are incorporated
in health projects.
Some children with educational
problems are found to perform poorly
on some visual tests, and the teachers
are very grateful for the chance to
gain further professional advice
regarding these children. It is hoped
that the liaison currently established
between the staff of the VEC and the
local school teachers will facilitate a
better understanding of the contribution
of vision to academic performance
during the formative years.
The VEC's Role in Research
The comprehensive visual screening
offered children as part of their
visit to the VEC provides an unparalleled
body of valuable date on the
ocular health and visual status of
Australian suburban school children.
As the program provides for classes
to visit the Centre every few years,
the data collected from the vision
examinations is being incorporated
into an extensive longitudinal study
using a reputedly stable population.
Several avenues of research are
facilitated by the VEC. From a purely
optometric view, much is still to be
learned from large sample studies of
normal children. As we have access
to many children at both the screening
and the follow-up stage, it will
be possible to evaluate the suitability
of the criteria used to determine acceptable
visual performance during
the screening. With increased attendance
at the Children's Vision Clinic,
a wider range of statistical analyses
on the treatment of visual anomalies
will be possible.
From an inter-disciplinary view,
well planned studies of visual performance
in the classroom and on the
sports field could result in massive
benefits to the young. The teachers
from nearby schools have been most
supportive of efforts by staff at UNSW
to investigate the relationship between
failed educational performance
and vision. Inter-faculty research by
the School of Optometry and the
School of Education has already been
initiated, using some of the classes
visiting the VEC.
How the VEC
Benefits Optometry
Optometrists in the vicinity of the
schools visiting the Vision Education
Centre will benefit directly, as parents
are informed that children requiring
further investigation will benefit from
the raised awareness of optometry in
the minds of the families whose children
have been involved in the program.
The school teachers are certainly
now more understanding of
the role that optometry plays in
providing primary vision care, and
should be able to play a key role in
referring children to optometrists.
Shortly, as our graduates move out
into the optometric community, it is
hoped that they will take with them
extra confidence to meet the demands
of young patients, and become
highly successful in the delivery of
vision care to the young. In the longer
term, it is hoped that they will in turn
motivate their older partners or employers
to develop a greater awareness
of paediatric optometry. Already,
our own visiting clinical consultants
who supervise our student
clinicians during VEC have indicated
a revived interest in the visual needs
of children.
With the growth of interest in
children's vision, it is expected that
there will come a demand for continuing
education in this area of
optometry. This can only serve to further
improve practitioner confidence
in the delivery of pediatric optometry
to the community.
The educational packages put
together for use within the university
setting can be adapted for use by
private practitioners in their own
practices and for visits to local schools
and pre-schools. Certainly the students
who have been involved with
the VEC will have witnessed the successful
delivery of suitable classroom
presentations and they should feel
more confident to participate in
public education programs on ocular
health and visual science.
How the VEC
Benefits the University
The Vision Education Centre provides
an opportunity for the University
to develop a higher profile in the
general community. Universities now
actively encourage greater liaison
with the community. Primary school
age children introduced to their local
university can visualize better the full
spectrum of formal education — primary,
secondary and tertiary. As part
of their visit to the VEC, children are
made aware of the similarity between
the structure of their own school and
the optometry school, and the additional
research functions of such an
institution.
Our government wishes to raise an
awareness of science in the young
community, and ensure a recognition
of the role of science in the modern
world. By providing an exciting science
lesson as part of an excursion,
it is hoped that these students' first
contact with a university will have a
lasting impression, and possibly
trigger a life-long interest in science.
A longitudinal study by Hilton and
Lee shows that early commitment
and preparation by children in
science-based subjects appears to be
critical in maintaining a persistence
with science as a career 4 .
Summary
The Vision Education Centre offers
potential for a highly successful
multi-level teaching facility with
benefits to all involved. The children
are given health care they otherwise
would not usually receive, plus a
hands-on science lesson to remember.
Optometry students gain skills
in working with children, pediatric
optometry, and educating the layman
of matters relating to the eye. The
teachers greatly value the support to
their health and science curriculum.
The parents are made aware of the
clinical facilities provided by the
School of Optometry for use by the
community. The Centre also provides
a mechanism whereby children can
gain a raised awareness of science,
and an insight into the full spectrum
of formal education. As the program
provides for classes to visit the Centre
every few years, the data collected
from the vision examinations will
provide researchers with valuable
longitudinal information about the
vision of Australian school children.
References
1. Levin HM. Raising productivity in higher
education. Journal of Higher Ed 1988; 62:241-
62.
2. Freddo TF. Academic restructuring: Options
and strategies. J. of Optom Ed 1991 Summer;
16(4):113-6.
3. Dayhaw-Barker P. Improving the quality of
teaching. J of Optom Ed 1991 Summer; 16
(4):117-20.
4. Hilton TL, Lee VE. Student interest and
persistence in science. J of Higher Ed 1988;
59:511-26.
86 Optometric Education

Optometric Externships
At Southern College of
Optometry:
A Director's
Bernard I. Sparks, III, M.S., O.D.
Perceptions
ulum at Southern College of Optometry.
Currently, fourth-year students
are required to successfully complete
two quarters of externship prior to
graduation. 2 As with other institutions,
35 these requirements are fulfilled
in settings such as military
bases, VA and Public Health Service
hospitals, inner-city health clinics,
optometric referral centers, and private
practices.
The actual education of the students
takes place with the direct
supervision and instruction of licensed,
highly trained optometrists
and/or ophthalmologists. These practitioners,
referred to as preceptors, are
also responsible for the performance
evaluation of the student clinicians.
As such, the preceptors represent the
vital link in fulfilling the institution's
educational objectives. 6
The success of the College's program
has required a considerable
amount of time, thought, planning,
on-going evaluation, and commitment
of resources. Beginning in 1985,
a restructuring of the externship program
was undertaken to address perceived
weaknesses of inconsistency
in its educational effectiveness. The
focus of this article will be upon five
guidelines (Table 1) which evolved
from this reorganization and which
have proven beneficial in the author's
administration of the program at
Southern College of Optometry.
Abstract
In recent year*, optometric externships
lunv become an important
component of clinical education.Thh
article nviezvs a variety of guidelines
which have pnnvn successful in the
administration of the externship program
at Southern College of Optometry.
Key words: optometric externships,
preceptor, adjunct faculty
Introduction
Since their inception in the 1970s, 1
optometric externships have become
an integral component of the curric-
Dr. Sparks is director of externships at the Southern
College of Optometry.
Volume 17, Number 3 / Spring 1992
a
\,
Guideline #1: Aims, Goals,
and Objectives
The aim of the College's externship
program is to assist the students in
developing greater clinical competency
by the provision of different
and diverse learning environments.
This is a broad declaration of purpose
and one which the College chose to
state in terms of process (i.e., to improve
clinical skills) rather than input
(i.e., to complete an externship). 78
The goals of the externship program
were more specific and represented
the College's global expectations
for the students. Care was taken
not to confuse educational goals with
behavioral objectives. The former
expresses the expectations for the
students while the latter details the
expectations of the students.
Behavioral objectives represented
the final phase at this level of development.
Unlike the aim, behavioral
objectives should always be expressed
in terms of output 8 or out-
87

TABLE 1
Guidelines For Externship Programs
1. Formulation of realistic, clearly defined aims, goals, and objectives.
2. Implementation of a means of preceptor/site selection which fulfills the institution's
educational expectations. ;
3. Dedication to a system of educating the preceptors on their role in the teaching
process.
4. Initiation of an equitable means of assigning students to externships.
5. Utilization of a means of summative and formative evaluation.
come. 9 In terms of an externship, the
objectives were developed to represent
the discreet, observable actions
and abilities which the extern must
successfully demonstrate to the preceptor
in an actual patient encounter.
Guideline #2: Preceptor/
Site Selection
The selection of preceptors proved
to be a challenging aspect of restructuring
the externship program. Of
particular importance was the decision
to include private practices in
addition to clinical facilities. Although
questions of validity have been raised
in regard to private practice externships,
10 a similar approach in medicine
11 has proven successful.
Care was taken to objectively
evaluate both the potential preceptor
and the practice. Evaluation encompassed,
but was not limited to, input
from other colleagues within the
practitioner's community, officers of
state and local optometric societies,
state board members, and other
knowledgeable references. The purpose
of the inquiry was to gather
information regarding the practitioner's
philosophies of practice, dedication
to optometry, and standing
within the profession.
The practice environment was
assessed in terms of patient volume
and diversity, available instrumentation,
and physical layout. A key factor
was the scope of practice. Specialized
practice settings which offered limited
optometric services were viewed
as a potential hindrance to the student
in terms of grasping optometry's
primary care mission.
Site visitations which would detail
and document on standardized forms
the practitioner's qualifications to
serve as a preceptor were deemed
vital. Consequently, the College
began supporting on-site evaluations
with resources and faculty/administrative
release time in line with the
approach reported by Wilson 5 and
Ruskiewicz. 12
Site visits have afforded an opportunity
to record preceptor interviews
and office tours via videotape. This
allowed the preceptor to be reviewed
by other members of the administrative
team in addition to becoming an
excellent resource for students contemplating
future externship assignments.
Practitioners who successfully fulfilled
the qualifications of the College
formalized their commitment by
signing a Memorandum of Agreement.
This agreement detailed the
obligations and responsibilities of all
parties involved within the program.
Once signed and approved by the administration,
the preceptors were
granted adjunct faculty status.
Finally, a means of limiting the size
of the preceptor pool was implemented.
The College has addressed
this issue by correlating the number
of locations with the current demographics
of the student body. By
limiting the program relative to class
size and the home states of enrolled
students, the institution is better able
to monitor the program.
Guideline #3:
Preceptor Education
Because the ability of a preceptor
to successfully fulfill the obligations
of a teaefeer can never be assumed,
the College has committed itself to
a concentrated program of preceptor
education. The approach has been
diversified to include printed materials
(i.e., handbooks, protocol guides,
etc.), personal counseling by the externship
administrators, and formal,
in-house instructional forums. At all
levels, the format has attempted to
address who the preceptors will be
teaching, what they are to teach, and
how they are to teach.
The provision of an externship
handbook represented the first step
in the process of educating preceptors.
The handbook was a clear and
simple way of providing an overall
framework for the adjunct faculty
members. Within it, the expectations
of the program were precisely stated
in regard to each educational objective.
Sections have been devoted to
topics such as evaluation and grading,
guidelines for student dress and
conduct, obligations of the preceptor
to the student and to the institution,
and criteria for the review of the externship
experience. Samples of
forms which are used during the
course of the rotation are also included
with a detailed explanation of
how each is to be completed. Finally,
a portion of the handbook was devoted
to a review of teaching principles.
Special emphasis was placed
upon techniques which have proven
beneficial to previous externship
students.
While the handbook provides instructions
at the individual level,
externship forums have proven to be
the most effective means of educating
and updating large groups of preceptors.
Forums are typically held once
or twice a year with the focus of required
participation being upon new
members of the adjunct faculty team.
The format allows for the free exchange
of ideas, observations, and
concerns of the preceptors, institutional
faculty, and administration.
Perhaps the most important concept
to be stressed in the forums is
that optometric education is a dynamic
process. In general, learning is
hindered when the student is placed
in the passive role of an observer. The
preceptors are educated to the necessity
of active student involvement in
the diagnosis, treatment, and management
of ocular conditions. Conversely,
preceptors are informed and
warned against the mentality of
involving students so aggressively
that they begin viewing them as "free
labor." In reality, the added time
needed to critique and comment on
the students' work may actually
reduce the preceptor's regular number
of doctor-patient interactions
during the course of an externship.
Finally, as with other disciplines, 13
preceptors must learn to embrace the
88 Optometric Education

ole of mentor with enthusiasm and
support one another in the common
goal of furthering optometric education.
Externship forums have provided
an opportunity to foster this
type of professional collegiality.
Guideline #4:
Assigning Externships
The determination of student assignments
has proven to be the most
complex process of the externship
program.
The goal is quite simple: to assign
students to the learning environment
which will best enhance their refinement
of diagnostic, therapeutic, and
management skills. The means of
achieving this, however, require a
detailed review and consideration of
several interrelated variables. The
most significant factors are usually
the student's level of academic success
and clinical proficiency as reflected
by cummulative GPA and
class rank. 4 Non-academic considerations
may include home state affiliation,
professional ambitions, financial
indebtedness, and family circumstances.
At Southern College, the process of
scheduling externships begins early
in the academic year. Preceptors are
polled concerning their willingness to
supervise students during the various
quarters of the upcoming school
year. This information is compiled
and translated into a listing of available
locations which is presented to
the third year students at the start
of the fall quarter. Early determination
allows for logistical planning on
the part of the students and focused
preparatory education on the part of
faculty.
Assigning students to specific
externship locations begins only after
all of the students have prioritized
their selections and submitted their
choices to the Director of Externships.
In the event that academic considerations
do not clearly indicate placement
for a student, the allied factors
are frequently utilized in determining
the assignment.
The last step involves notifying the
preceptors of the tentative assignments.
Preceptors are allowed time to
review the assignments in light of
prior personal or professional commitments
and accept or reject assignments
accordingly. Once written confirmation
is received from the preceptors,
the students' externships are
considered finalized.
Guideline #5: Evaluation
Evaluation is perhaps the most
critical factor in the success or failure
of an externship program. When
properly implemented, evaluation
goes far beyond the obvious determination
of a student's grade. A successful
process must be ongoing in
length, broad in scope, multidimentional
in purpose, and should yield
data which are both summative and
formative in nature. 1415 Principles of
campus-oriented clinical evaluation
have proven equally adaptable to the
externship setting.
Summative evaluation sums up the
output of both the student and the
preceptor at the conclusion of the externship.
In arriving at the student's
assessment, multiple variables 15 are
always evaluated. The areas of technical
skills, analytical abilities, management
capabilities, and professional
demeanor are basic to the
assessment. The preceptors' evaluations
are made from first-hand,
supervised observations and interactions
with the student.
Conversely, the students' reviews
of the preceptors are also broad in
scope. Information concerning the
strengths and weaknesses of the preceptor,
ancillary staff, patient population,
and physical layout is openly
provided to the Director of Externships
in written form. These confidential
reviews focus on factual and perceived
events occurring during the
course of the assignment.
In contrast to summative evaluation,
formative evaluation occurs
throughout the externship. The purpose
is to modify and enhance the
learning environment during the
course of the current assignment. The
process also allows for a restructuring
and redirecting of future assignments
based on previous experiences and
evaluations.
Preceptors dedicate a set time for
periodic program reviews with the
student clinicians. These interactions
openly address the concerns of the
preceptors regarding student performance
and the perceptions of the student
in light of the experience being
provided. All parties must be willing
to provide and accept frank and objective
feedback if on-line modifications
and enhancements are to take
place.
From the College's perspective, the
process transcends the experiences of
students and preceptors over the
course of time. Quarterly, semiannual,
and annual reviews by the
administrative team are essential if
formative evaluation is to result in
meaningful improvements at the program
level. Frequent, open, and objective
communication between the
institution, the students, and the preceptors
has proven to be a prerequisite
for this type of assessment to
be productive. 6
Conclusion
In the 1990-91 academic year, students
averaged over 1000 patient contacts
during the course of their externships.
Over a third of these
patients exhibited significant ocular
or systemic related pathologies. In the
foreseeable future, experiences such
as these will continue to have a positive
impact on the education of
students at Southern College of
Optometry. It is hoped that the
guidelines presented in this article
will be of assistance to other institutions
in achieving the same or
greater levels of success.
Bibliography
1. Speilberger D. Profile: Southern College of
Optometry - a leader in the profession. JOE
1979;4(3):16-20.
2. Student Catalogue. Southern College of
Optometry 1990-91:19.
3. Paramore JE. The off-campus clinical
program of the college of optometry, Ferris
State College. JOE 1982;7(3):12-14.
4. Nussenblatt H. University of Houston
College of Optometry externship program.
JOE 1982;7(3):15-17.
5. Wilson RJ. A clinical curriculum model for
training fourth-year optometry students.
JOE 1990;15(3):72-79.
6. Davis LL, Barham PD. Get the most from
your preceptorship program. Nurs Outlook
1989;37(4):167-171.
7. Externship Handbook. Southern College of
Optometry 1988.
8. Romiszowski AJ. Designing Instructional
Systems. Nichols Publishing, New York.
1981.
9. Abplanalp P. Behavioral objectives: A means
to establish profession-wide clinical performance
standards. JOE 1982;8(2):6-9.
10. Borish IM. Clinical training via external or
adjunct assignments. JOE 1982;7(3):4-5.
11. Rabinowitz HK. Student clinical experiences
in family medicine: A comparison of
clerkships and preceptorships. Fam Pract
Res J 1989;8(2):92-99.
12. Ruskiewicz J. Evaluation of quality assurance
programs for externships. JOE 1982;
7(3):8-ll.
13. Modic MB, Bowman C. Developing a preceptor
program: what are the ingredients?
J Nurs Staff Dev 1989;5(2):78-83.
14. Werner DL. Monitoring the quality of care
in an optometric clinic. JOE 1978;3(3,4):19-
22.
15. Eskridge JB. The assessment of clinical
competence in a practical setting. JOE
1981;7(2):12-14.
Volume 17, Number 3 / Spring 1992 89

Developing
Optometric
Preceptorships:
Goal Delineation and
Program Development
Irving L. Dunsky, M.S., O.D.
practice models and generally do not
have a realistic basis for deciding on
a practice setting in optometry.
One way to reinforce the growing
interest of optometry students in
primary care careers is by providing
opportunities for them to gain firsthand
experience with primary care
optometrists in their everyday practice.
The evidence from available
sources indicates that these experiences
are valuable, not only as a way
of helping students make career
decisions, but also as clinical and
practice educational experiences 34 .
Schools and colleges of optometry
that have developed and administered
preceptorships in a variety of
settings,for multiple purposes and
with disparate characteristics and
educational objectives, have acquired
considerable experience 5 - 6 . This paper
is an attempt to distill some of this
information so that new ventures into
preceptorships may benefit from the
experience of others. It deals with
issues in goal delineation and program
development. Future papers
will discuss such topics as curriculum,
program operation and program
evaluation.
Abstract
This paper describes some of the
processes involved in developing
optometric preceptorships for schools
and colleges of optometry. Of a five
process approach (goal delineation,
program development, curriculum,
program operations and program
evaluation), only the first two
processes are discussed in this paper.
Goal delineation is categorized and
discussed. Program droelopment,
including site selection and preceptor
selection and recruitment, is discussed
fully. This paper presents
information so that mw ventures
into preceptorships may benefit from
the experience of others.
Key Words: preceptorships, goal
delineation, program development
Dr. Dunsky is a professor at the Southern College
of Optometry.
90
Introduction
Off-campus preceptorships for
medical students are not a new phenomenon
in medical education. The
University of Wisconsin Medical
School has had a continuous preceptorship
since 1926 1 . In the past several
years, some optometry schools, student
groups and community based
optometrists have shown increasing
interest in the learning opportunities
provided by preceptorship experiences.
This interest is in concert with
a corresponding increase in the number
of preceptorship programs for
dentistry and other health professions
2 .
The learning opportunities provided
by preceptorship experiences
can extend from practice management
to specialty practice in a solo
practice group or team practice setting.
Exposure to these practice
models and practitioner roles are important,
since students who see optometric
faculty only in clinical academic
settings have limited role and
Goal Delineation
Goals for a preceptorship program,
as defined by this report,are divided
into three categories: 1) Long Range
Goals; 2) Specific Learning Goals,
which deal with the acquisition of
knowledge about an experience with
particular aspects of the learning environment;
and 3) General Attitudinal
and Value Goals, which are designed
to alter, reinforce or introduce what
can be judged to be desirable values
or orientations toward aspects of
optometric practice. These goals are
shown in Table 1.
The areas included in the list of
goals represent the kinds of objectives
repeatedly described by different
preceptorship programs 7 - 8 . Whatever
the goals selected for a particular
program, careful attention should be
given to the relationship of each program
characteristic to the accomplishment
of stated goals. The following
examples demonstrate this relationship.
1. Long-range goals - to provide more
primary care optometric practitioners
for underserved areas, such as rural
and inner city communities.
Program characteristic - priority is
given to recruitment of preceptors in
underserved areas, a mechanism is
Optometric Education

Long Range Goals
TABLE 1
Goals of a Preceptorship Program
Specific Learning Goals
General Attitude & Value Goals
1. To provide more primary care
optometrists.
2. To encourage students to enter optometric
practice in such underserved
areas as rural and inner city
communities.
3. To broaden the scope of community
optometric care by developing linkage
between the academic institutions of
optometry and optometric providers in
communities.
1. To provide a clinical learning experience
in primary care as part of the
optometry school curriculum.
2. To teach students about the kinds of
clinical problems encountered in an
office practice as compared to an academic
clinical setting, including mechanisms
for ensuring comprehensive and
continuing care.
3. To teach students the diagnostic and
therapeutic techniques appropriate to
an office practice.
1. To provide an opportunity for students
to explore and evaluate their own
career goals and values in optometry.
2. To provide an opportunity for the student
to experience and evaluate primary
care as a career path.
3. To allow the student to observe and
experience the optometric and personal
lifestyle of a primary care optometrist in
a community.
developed to assess the impact of the
experience on the career choices of
optometric students.
2. Specific learning goal teach students
how to use the available health
resources in an area.
Program characteristic - optometry
students have an opportunity to use
health resources, and will be evaluated
on how well they use resources.
3. General Attitude and value goals - to
provide an opportunity for students
to explore and evaluate career goals
and values in optometry.
Program characteristic - optometry
students identify values and career
goals both before and after the preceptorship.
The change is noted and
career counseling is made available.
Program Development
Initiation
Preceptorship programs may be
initiated by any one of the three
groups typically involved in a preceptorship
experience: optometric faculty
and/or administrators, optometric
students and community optometrists.
Although a particular group
often formulates the initial idea,the
cooperation of the other two groups
is necessary for success.
This does not mean that an initiator
with only a vague idea should immediately
solicit the collaboration of
others. To gain needed support, initiators
should familiarize themselves
with some basic issues in program
development. They should have a
clear conception of the goals of the
proposed learning experience and
4. To teach students to view and treat
patients in the context of their lifestyle,
occupation and community.
5. To permit students to apply basic
classroom knowledge in the biomedical
and behavioral sciences to direct
patient care situations.
6. To broaden and enhance the student's
interviewing and related skills through
experience in providing care in an office
setting.
7. To provide knowledge through experience
of the referral and consultation
processes in a community setting with
multiple and varied health resources.
8. To help the student understand the
role and lifestyle of the primary care
optometrist in the total health care system
of a community. ....
9. To enable the student to learn though
experience with the roles of office personnel,
e.g., office manager, optometric
technicians/assistants and dispensers.
10. To develop in the student an understanding
of preventive health practices
and their use in a primary care practice.
11. To provide an understanding of public
health and environmental factors in
relation to the private practice of
optometry.
12. To expose the student to the business
and monitoring aspects of optometric
practice, such as bookkeeping, record
systems, appointment scheduling and
payment mechanisms.
4. To allow the student to become
acquainted with the methods used by
the primary care optometrist for continuing
education.
5. To encourage the patient to value
such concepts and practices as continuity
of care, treatment in a family/community
context and the optometrypatient
relationship as they affect health
and illness.
6. To develop an awareness in the student
of roles and skills of other health
professionals.
should be prepared to answer potential
questions from each group whose
collaboration is sought. For example,
optometric faculty might be concerned
with: monitoring the educational
quality of the experience; the
qualifications of the proposed preceptors;
whether the curriculum already
includes similar learning goals; the
effort and time required by faculty;
and the method of evaluation of
students.
Optometry school administrators
will be concerned with the same
issues 9 , as well as with factors such
as liability and administration costs
and procedures.
Optometry students will be concerned
with: the program's place in
the overall curriculum; the program's
educational value relative to other
curricular opportunities; whether the
program will be required or elective;
the extent to which they will have
freedom to choose the site and the
preceptor; methods for evaluating
their performance; and financial aid.
Volume 17, Number 3 / Spring 1992 91

As potential preceptors, optometrists
in the community will be
concerned with: the commitment
expected of them; the level and
quality of students who will participate;
whether they will be expected
to provide housing for students;
liability; and remuneration or incentives
that might be offered.
In addition, the concerns of the lay
community members who will come
into contact with students should be
considered. These include: the kind
of clinical supervision provided students;
the extent to which the student's
presence may delay or interfere
with the provision of eye and
vision care by community optometrists;
and the social behavior of
students.
When an optometric institution
initiates the preceptorship, good
communication between faculty and
preceptors is key to maintaining the
program. Preceptorships provide an
excellent opportunity for interchange
between the academic and practicing
optometrist and include potential for
each to learn about the other's role
within the health care system. The
cooperation of students, preceptors
and faculty in initiating a program
offers the best potential for meeting
the needs and expectations of all
three groups and for making the program
educational and relevant.
Frequently, new preceptors are
concerned about their ability to be
effective teachers. It is important to
emphasize their unique experience,
knowledge and skills as distinct from
the expertise of institutional faculty.
As a way of recognizing the preceptors'
key teaching role, most programs
consider them "community
faculty" or "clinical faculty." 10
Site Selection
Site selection involves deciding on
particular communities and specific
practice organizations within the
communities. The kind of communities
and practice organizations
selected will depend on the nature
of the educational experience desired
for students. Sites in inner city areas
may be the focus of one preceptor
program; remote rural sites may fit
into the goals of another; while still
others may wish to offer experience
in both areas. If underserved areas are
not of particular interest to a program,
sites may be chosen anywhere, with
perhaps greater attention focused on
the practice characteristics (e.g., solo
versus group or team model) or
clinical learning offered the student.
Again, selection of sites will be partly
determined by the program's goals
and objectives.
Information concerning the desired
criteria for site selection can be requested
on a Preceptor Application
Form (Fig.l). Thus, if a program goal
involves exposure to team practice
models, information can be gathered
about site staffing and allocation of
responsibilities. Similar information
requests can be made with regard to
other criteria. Or, if a limited range
of site characteristics is desired, the
initial recruitment letter to optometrists
can state these requirements so
that all respondents meet the desired
attributes.
Serving as a preceptor
involves a substantial
commitment in time,
energy, patience and
willingness to "learn as
you go along."
Preceptor Selection and Recruitment
Factors that might be considered
in selecting effective preceptors include
optometric specialty, teaching
ability, clinical competence, time
available for teaching and commitment
to program goals. To judge the
appropriateness of an optometrist for
the role of preceptor, the program
coordinator might consider such
factors as: involvement in formal and
informal continuing education activities;
national board certification;
membership in optometric societies;
affiliations with hospitals; nature of
practice (e.g., percent of patients seen
for acute problems versus those seen
for preventive and maintenance care);
referral patterns and use of ancilliary
health personnel.
Apart from such indications, perhaps
the most useful index is the
optometrist's interest in serving as a
preceptor. To determine the extent
and quality of interest, the program's
characteristics and its expectations of
him/her should be provided in detail.
Serving as a preceptor involves a substantial
commitment in time, energy,
patience and willingness to "learn as
you go along."
In identifying potential preceptors,
it is helpful to consult with local
societies or state associations. Since
they have greater continuing contact
with community optometrists, these
groups should be able to identify
those who possess adequate clinical
skills and facilities, and provide professional
and personal role models.
Potential preceptors should be
given, in addition to a thorough description
of program characteristics
and expectations, information on the
various incentives offered. For many
optometrists a major appeal is the
satisfaction gained through participation
in the optometric education of
future optometrists and the stimulation
provided by the student's presence.
An optometrist also may be interested
in attracting a future partner
or replacement.
Other incentives offered include an
opportunity to apply for a clinical
facility appointment or automatic
receipt of such status, free participation
in continuing education programs,
use of the school's optometric
library services, continuing education
credit, increased familiarity with and
access to the academic institution's
consultative services, receipt of a certificate
stating the contribution to optometric
education, invitations to
lecture within the optometry school
curriculum and financial remuneration.
The last incentive is one of the most
controversial. Those who favor payment
maintain that a busy practitioner
should be reimbursed so that
he/she can make the needed time for
teaching available. Those against payment
for preceptors argue that payment
is unnecessary and escalates
program costs; that these funds might
better be spent for housing and travel
costs for students; that preceptor
payment is an open-ended expense
that is difficult to administer and that
limited funds will limit the expansion
of the preceptor program so that
potential preceptors in some communities
may have to wait until the budget
will permit their participation.
Another important factor is the
extent of time commitment required
of preceptors. If a program has a significant
pool of preceptors who will
have one or two students a year for
92 Optometric Education

Name
Address
Phone ; Date of Birth.
Residencies (types and dates).
Specialty Board Certified Yes No
Type of Practice Solo Partnership Group (Number in Group).
Other (speci fy)
Hospital Affiliations
Membership in Optometric Societies
Number of years in in practice present location
Approximate number of patients seen per week:
Percent patient seen whose problems are: Acute Recurrent
Chron i c
Percent office visits for regular check-ups or "preventive
maintenance":
Please Percent list patients the kinds seen who and are numbers referred of ancillary by other OD's. personnel employed
in your practice who might be involved in teaching students
Check those areas you include in your practice of optometry:
Pediatrics
Vision Therapy
Geriatrics
Therapeutic Optometry
Low Vision
Contact Lenses
Nutritional Counseling
Electrodiagriostics
In-Office Fabrication
Other
In what kind of continuing education activities are you involved?
Would you be able to make necessary housing arrangements for the
student during the preceptorship? Yes No
If no, type of housing available.
Have you had previous preceptees? Yes No_
If yes, how man?.
Could your practice accommodate two preceptees at the same time?
Yes No
How many students per year would you be willing to take?
Do you accept out-of-state students? Yes. No
Any other special preferences or restrictions.
Any special features of your practice.
Are there any special optometric projects in your community that
would interest a student? ;
Figure 1. Preceptor Application Form
Volume 17, Number 3 / Spring 1992 93

a period of 4 to 6 weeks, payment
may not be necessary. However, if a
preceptor is expected to work with
students on a regular, year round
basis,it may be unrealistic to expect
such a time commitment without
financial remuneration.
The prevailing ethic of the particular
optometric community also
should be taken into account. In some
communities, optometrists may
expect to volunteer their time for a
variety of activities. In others, this
attitude may not prevail. Those
responsible for making decisions on
payment of preceptors should be
sensitive to such values and attitudes.
Selection of Preceptees
Level of Student: A major variable in
determining which optometry students
to select for a preceptorship is
the level of student for whom the
experience is designed.
A program that hopes to expose
optometry students early in their
training to a particular practice situation
will affect the activities and expectations
for students, as well as the
kind of training provided by preceptors.
More advanced students may
become involved in direct patient
care and require in-depth teaching in
clinical areas.
The level of student desired will
affect a variety of preceptor program
characteristics, and the decision
should be made early in the planning
of a preceptorship. Required preceptor
programs will not have to be
concerned with student recruitment.
However, elective programs must
deal with recruitment and selection
of students. All preceptorship programs
must develop a method of
matching students with preceptors
and sites.
Criteria for matching preceptors
and preceptees depend on a variety
of program characteristics. Some preceptor
programs can sponsor meetings
for preceptees and preceptors to
interact, exchange information and
form a basis for preferences in future
selection. Where this is not feasible,
written information about participants
may be provided, or telephone
contact and letter exchange may be
encouraged.
It is helpful for the preceptor program
coordinator to maintain a file
on each preceptorship for students to
review. These files should include
Chamber of Commerce information
on the community, site visit reports
by institutional faculty and evaluations
by former students. Where
possible, prospective students should
be referred to former participants for
first-hand information.
Most preceptorship programs
make an effort to allow students to
choose among the sites and experiences
available. In addition, preceptors
may have particular preferences with
regard to the kinds of students placed
with them, such as sex or marital
status. Dealing with these details of
student placement requires coordination
by the preceptorship staff and
forethought in recognizing potential
areas of conflict. Matching can be
greatly facilitated when both preceptors
and students are well known to
the staff.
A future report will deal with such
logistical aspects as housing, transportation,
financial assistance and the
preceptee's spouse and/or family.
Length of Preceptorship Experience
Another area of controversy among
preceptorship promoters is the
optimal length of the training. Some
feel that an intensive experience of
four to six weeks is sufficient to
accomplish a wide variety of goals,
including enabling students to make
career decisions about optometry in
underserved settings. Others feel
strongly that such a length of time
only serves as an orientation period
and that a much longer period (like
eight to ten weeks)is required for a
student to appreciate and/or evaluate
settings as future practice options.
Some professional students feel that
the preceptorship experience should
be reinforced at various points during
the student's training.
There are, however, practical constraints
related to decisions concerning
length of preceptorship experiences,
such as available time within
an established curriculum. Unless the
developers of a program are willing
and able to attempt major alterations
in a curriculum so that students can
devote larger blocks of time to an offcampus
experience, preceptor program
goals and characteristics may
have to be developed and/or modified
to fit within the bounds of what is
possible, rather than what may be
desirable.
Once a decision as to length of the
experience has been made, preceptor
program designers will find that this
factor likely affects the number of
goals that may be accomplished and
the methods to be used in achieving
them.
Conclusion
This paper has presented information
relevant to some aspects of
preceptorship development. It discusses
in detail preceptorship goal
delineations and various aspects of
program development, such as site
selection, selection of preceptors and
preceptees, and length of preceptorship
experience. A future paper will
discuss curriculum, program operation
and evaluation.
References
1. Bardeen CR. Extramural clinical teaching-
The Preceptor system at Wisconsin. Wisconsin
Med J 1982;27(3):141-146.
2. Sax E. A directory of preceptorship programs
in the health professions. National
Health Council, NY, August 1975.
3. Martin JL, Paskowitz J. Planned acquisition
of clinical experience. Supervisory Nurse
1975;6(9):20-22.
4. Chyatte SB. Medical student training and
career choice selection. Arch Physical Med
Rehab 1971;52(7):306-310.
5. Nussenblatt H. University of Houston
College of Optometry externship program.
Jour Optom Educ 1982;7(3):15-17.
6. Paramore JE. The off-campus clinical program
at the College of Optometry, Ferris
State College. Jour Optom Educ 1982;7(3):12-
14.
7. Mulvaney TJ. What are the needs, and do
we need to make any changes in our resident
education program? Trans Am Acad
Ophthal Otolaryn 1975;80(4):397-400.
8. Caine RL. The dental externship: An
educational methodology for extramural
experiences. Jour Dental Educ 1975;39(U):
737-739.
9. Ruskiewicz J. Evaluation of quality assurance
programs for externships. Jour Optom
Educ 1982;7(3):8U.
10. Firestone F. What being a preceptor can
mean to you. Medical Times 1975;102(12):64-
66.
94 Optometric Education

RESOURCES
NREV
The Eye in Systemic Disease,
Daniel H. Gold and Thomas Weingeist,
ed., J.B. Lippincott, Philadelphia,
PA, 1990, 736 pages, 350 illustrations,
63 tables, $87.50.
The Eye in Systemic Disease is a
comprehensive reference devoted
to the study of the eye as it is
affected by systemic disease. The
book is organized in 22 (parts) traditional
clinical disease categories
according to the organ system or
etiology and/or clinical manifestation
of the disease. The authors
made a conscious decision to leave
out the area of neurologic disorders
and to discuss the neuroophthalmic
complications under
the headings of the individual disease
entities. Each of these parts is
conveniently sub-divided into sections
and chapters making the
text extremely easy to use. An
Three hundred and eighteen clinicians
with specialities in specific
diseases contributed in the preparation
of the 230 chapters. Each
chapter examines essential features
of a specific disease, its ocular
and systemic manifestations
and the most recent clinical and
laboratory findings. Patient management
and/or treatment guidelines
are outlined wherever applicable.
The authors describe their
work as "an overview of the subject,
enabling the reader to better
understand why these complications
occur, and to see underlying
patterns that produce the constellation
of signs and symptoms that
we recognize as individual clinical
disease entities." The pathophysiologic
mechanisms are addressed
as well as is possible in any text
that provides an overview.
This reference text is well organized
and easy to read. It should
have particular value for practitioners
who are interested in primary
health care, primary eye care
and specialists who are interested
in how the eye is affected by systemic
disease. Every educator who
is involved in the teaching of ocular
diseases should have access to
this comprehensive text.
Guest Reviewer:
P. Sarita Soni, O.D., M.S.
Indiana University
School of Optometry
The Geometrical Optics
Workbook, David S. Loshin,
Butterworth-Heinemann, 1991, 202
pp., soft cover, $24.95.
Writing a workbook in geometrical
optics is a daunting task
because most textbook authors
use idiosyncratic nomenclature
and sign conventions. The students
who most need additional
practice in problem-solving frequently
have not mastered the
nomenclature and conventions of
their assigned textbook. Therefore,
it is commendable that Dr. Loshin
has been able to succeed as well
as he has. The positive qualities of
his workbook are a readily comprehended
conversational style,
and an explicit problem-solving
methodology. By incorporating
his sign convention in his many
illustrations, i.e., using arrowheads
to indicate the direction a quantity
is measured, he reinforces the
use of the appropriate convention.
He has supplied hundreds of
examples and hundreds more
problems to be solved by the
student.
Dr. Loshin offers helpful understandings
of concepts that often
confuse students. For example, on
discussing refraction, he points
out that refraction does not necessarily
mean that a ray is bent, but
that its velocity is changed. He
offers a useful rule on transmission
through a prism — no ray
will be transmitted if the apical
angle is greater than twice the
critical angle.
This first edition contains many
typographical errors. Most of the
errors are obvious and will not
confuse students. A few conceptual
errors have crept in. For
example, after correctly discussing
apparent depth, the general rules
at the bottom of p. 40 are inadvertently
misstated. I also would
take issue with his definition (p.
38) of index: "n=Index of space
where real object is located." I
would have it read,. . . "where
real or virtual object is located." I
understand that the publisher will
supply an errata sheet to obviate
these criticisms.
I sum, the Geometrical Optics
Workbook places demands on the
student's ability to solve problems.
This workbook will concretely
help students in acquiring
the correct approach to their
solution.
Guest reviewer:
Milton Katz, O.D.
SUNY State College of Optometry
Correction
The references for the article,
"Continuing Education Needs
of Ohio Optometrists: A Comparison
with Other Health Care
Providers," (Vol. 17, No. 2, p. 41)
were inadvertently omitted.
They should have been:
1. Cervero RJ. A factor analytic study of
physicians' reasons for participating
in continuing education. J Med Educ
1981; 56(l):29-34.
2. Mcintosh J. Some answers to questions
about mandatory continuing
education. J Optom Educ 1982; 7(4):
20-21.
3. Smith IK, Smith JO, Ross GR. Needs
assessment: an overview for health
educators. Mobius 1982; 2:52-59.
4. Blockstein WL. Interdisciplinary continuing
education. Mobius 1983;3:70.
5. Roberts S and Scott J. Assessing continuing
education needs of five allied
health professions in rural California.
Journal of Continuing Education in
the Health Professions 1988; 8:55-61.
Volume 17, Number 3 / Spring 1992 95

VariluxLenses:
The Revolution
Turned Institution
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Uust when the "baby"boom" hit
full stride, Varilux patented the first
- »' gSoafiessi»e*addition Jens, touching
j££^»?£folutfbri in eye care^day,
3¥t t-'^ W 9S:percent of If.S. eye^are .
{:-' practitioners are fitting progres-
£jfe?*.' '&v$£< The presbyopic population is
«&.*; /growing twice as fast as the general
p!:*-'. papulation. Opportunity abounds.
^./.--•'tAs-Hi&v tO-"Mt 3S Hs^fiKaK
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Js?'^SSfi5ptheV progressive lenses have been
lK%fe^ldted.t^rnore clinical testing than
^'H.w'hjx'Plus" and Varilux Infinity.^
i i '$ver\ in the toughest tests, success
,!*.; juries are high:
V- -/i Inexperienced fitters in a multi-clinic
'"• ~* study averaged 92 percent success
V : ' ir> a random, unscreened population. 1
- • Elkin found that 83 percent ot patients
.. who could not adapt to mono-design
PALs were successful with Varilux
Infinity 2
m Cho cited success in 97.5 percent of
., all presbyopes and 86.8 percent of
' adapted bifocal wearers using both
Varilux Infinity and Varilux Plus. 3
Success Assured.
Over the years, we've enjoyed a special
relationship with the independent eye
care practitioner. Varilux and its select
authorized laboratory network support
you with quality products, service, training,
national consumer advertising,
and a comprehensive Patient Satisfaction
Guarantee. We make it easy for
you to succeed
The time of the progressive lens has
come Today the majority of presbyopes
who are presented with the choice will
choose progressives over bifocals And
they II invest more for the privilege So
if Varilux lenses aren't currently your
multifocal of choice, you may want to
re-think your presbyopia management
strategy for the 90s. All you'll need
for success are Varilux lenses and
the confidence of knowing you are
recommending not just a lens, but an
institution.
VARILUX
-41
Varilux Corporation ^
322 Lakeside'rJrive'.
Foster City. CA 94404'
1-800-BEST-PAL '"
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